Provider Demographics
NPI:1831255819
Name:ROGERS, SARAH (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11319 LIBERTY MILLS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-2035
Mailing Address - Country:US
Mailing Address - Phone:540-672-4904
Mailing Address - Fax:
Practice Address - Street 1:11319 LIBERTY MILLS RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-2035
Practice Address - Country:US
Practice Address - Phone:540-672-4904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist